Hyperemia reduction after administration of a fixed combination of bimatoprost and timolol maleate to patients on prostaglandin or prostamide monotherapy

J Ocul Pharmacol Ther. 2010 Dec;26(6):611-5. doi: 10.1089/jop.2010.0038. Epub 2010 Oct 28.


Objective: The aim of this study was to evaluate the change in hyperemia and intraocular pressure (IOP) in patients who switch from prostaglandin or prostamide to a fixed combination of prostamide and timolol maleate.

Design: A multicenter, longitudinal, noncontrolled, nonrandomized open trial was conducted.

Participants: One hundred forty-four patients (282 eyes) were selected: 60 (41.6%) were on travaprost, 51 (35.4%) on bimatoprost, and 33 (22.9%) on latanoprost. All patients included were unable to attain adequate IOP control with monotherapy and had no contraindications to β-blockers.

Intervention: Patients were treated with a fixed combination of bimatoprost and timolol maleate. Hyperemia was evaluated using a referential table, and IOP was measured at 8:00, 12:00, and 16:00 h both before and after 4 months of treatment.

Main outcome: IOP and hyperemia were compared at 2 time points: pretreatment and after 4 months. The mean of the 3 IOP measurements taken at various points during the day was considered for analysis. Generalized estimating equations were used for repeated measures and intereye dependency adjustments.

Results: Hyperemia and IOP were reduced in all 3 groups, with the same pattern for both eyes. The bimatoprost group had the highest levels of hyperemia before treatment when compared with the latanoprost as well as the travaprost group and had the greatest reduction in hyperemia after treatment (P < 0.01). Regarding IOP, all 3 groups had a significant reduction (P < 0.001), but the bimatoprost group had a lower pretreatment IOP when compared with the travaprost and latanoprost groups.

Conclusion: A significant reduction in hyperemia was found after switching from monotherapy with prostaglandins or prostamide to a fixed combination of prostamide and a β-blocker. IOP reduction was significant after the intervention in all 3 groups.

Publication types

  • Comparative Study
  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Amides / administration & dosage
  • Amides / adverse effects*
  • Amides / therapeutic use
  • Antihypertensive Agents / administration & dosage
  • Antihypertensive Agents / adverse effects*
  • Antihypertensive Agents / therapeutic use
  • Bimatoprost
  • Cloprostenol / administration & dosage
  • Cloprostenol / adverse effects
  • Cloprostenol / analogs & derivatives*
  • Cloprostenol / therapeutic use
  • Drug Combinations
  • Follow-Up Studies
  • Glaucoma / drug therapy
  • Humans
  • Hyperemia / chemically induced*
  • Hyperemia / epidemiology
  • Intraocular Pressure / drug effects
  • Latanoprost
  • Longitudinal Studies
  • Prostaglandins F, Synthetic / administration & dosage
  • Prostaglandins F, Synthetic / adverse effects
  • Time Factors
  • Timolol / administration & dosage
  • Timolol / adverse effects*
  • Timolol / therapeutic use
  • Travoprost


  • Amides
  • Antihypertensive Agents
  • Drug Combinations
  • Prostaglandins F, Synthetic
  • Cloprostenol
  • Latanoprost
  • Timolol
  • Bimatoprost
  • Travoprost